The information and communication infrastructure in modern medical facilities are almost exclusively electronic-based these days. Medical information in form of electronic data files for example images files or text files are distributed across picture archive and communication systems (PACS) and hospital information services (HIS) connected either hospital-wide in an intranet network or nationally of even internationally in the familiar internet.
Medical personnel, for example radiologists need to retrieve by retrieval means image files from the PCAS or the HIS for their diagnostic work.
A radiological diagnostic process proceeds roughly along the following lines. In order to reach a diagnostic decision the radiologist must visually examine not only one, but a series of image files.
The image files are available in the well known “Digital Imaging and Communications in Medicine” (DICOM) standard or format. The image files may be slices or parts of higher dimensional volumetric data sets. The volumetric data sets have been acquired from a patient by medical imaging modalities for example computer tomographs (CT), positron emission tomographs (PET) or X-ray units.
In a time-consuming but crucial step, the radiologist is carefully examining by means of a number of dedicated images viewers or simply “viewers” the series of the image files one-by-one in order to locate suspicious features.
The features define locations of interest in some of the image files. The locations of interest along with the radiologist's interpretation thereof constitute a medical “finding” with respect to the image file representing that location of interest. The totality of all findings is then used by the radiologist to either confirm or reject a diagnosis, that is, to reach a diagnostic decision.
Within the course of examining the images files, the radiologist makes notes concerning, for example, measuring information with respect to the locations of interest such as a diameter of a liver shown in the image files. The measurement information, along with other observations such as textual notes and the image files showing the locations of interest can then be compiled into a medical report.
The medical report is then later on possibly transferred to a referring radiologist who wishes to review the image files together with the notes in the medical report, in order to confirm or reject the diagnosis of the radiologist.
However the radiologist may wish to put the image files, the observations and measurement information on hold, in order to discuss the findings with another diagnostician before the radiologist decides to compile the medical report.
The radiological diagnostic process as outlined above normally proceeds in different phases. In a first phase the radiologist normally takes a quick look at all relevant image files just to get a broad overview of the medical information available.
In a second phase the radiologist looks more carefully for the locations of interest in some of the image files, and puts down notes electronically by means of a marking tool, on paper or by using a dictaphone about the observations and the measurement values in order to more accurately describe the locations of interest.
In a third phase the radiologist is then reviewing the image files having the locations of interest in order to for example discuss his or her diagnostic decision on the basis of the findings form the second phases with another radiologist. Also in the third phase the radiologist may whish to be able to quickly retrieve a number of the image files having a particular region of interest and to discuss the respective findings with the other radiologist. Or the radiologist may wish to make a final selection from among the images files suitable to best represent the regions of interest therein and to finally compile the “top 10” of the image files into the medical report.